This is a descriptive study of chronic ischaemia of the lower limb caused by atherosclerotic disease in 588 patients. The study was performed over 34 years in a tertiary clinic in the central province of Sri Lanka. It was found that the pattern of occlusions were similar to that of other reports on western patients. However, critical ischaemia was seen in 57% of Sri Lankan patients, suggesting a more florid disease. Pioneering efforts of reconstructive surgery in 278 patients and in-hospital results are presented.
Breast cancer (BC) ranks the highest among all cancers of women worldwide. Mammography is the most widely utilized imaging tool for evaluation of breast cancer with the final diagnosis being made on histopathology. This study aimed at describing the demographic, clinical and mammographic characteristics of histologically proven invasive ductal carcinoma (IDC) of breast in a group of Sri Lankan women. The study was carried out using a database on mammography maintained by the principal investigator. Study sample consisted of 177 subjects. The mean age of subjects was 52.2 years (SD ± 1.1). Majority (63.8%) were postmenopausalwomen. 93% of them presented with symptomatic breast disease, and the commonest symptom was a palpable mass (90.7%). Presentation for mammography after observing symptoms showed a median delay of 28 days. BC was found mostly in involuting type of breasts. Commonest mammography characteristic was a mass (86.4%). Size of the mass was between 2 cm to 5 cm in majority (84.3%) with T stage II disease. In conclusion, mean age of the subjects was comparable to other Asian countries but relatively lower than that of the west. Majority of patients presented with a palpable mass within four weeks from the onset of symptoms. The size of the mass did not show a significant correlation with the duration of symptoms and the age. This study did not find a significant association between mammographic breast density with IDC.
A 66-year-old patient was admitted to a peripheral hospital with necrotising fasciitis and septic shock, with a background history of severe co-morbid diseases. The septic shock was managed at an intensive care unit with IV vasopressors and IV antibiotics via right internal jugular central venous catheter (CVC). Insertion of CVC was complicated by migration of guide wire in to the inferior vena cava (IVC). This case illustrates the migration of a guide wire as a complication of CVC insertion, and the subsequent retrieval of this guide wire.
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